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This report by AARP’s Public Policy Institute, The Commonwealth Fund and The SCAN Foundation shows some states significantly out-perform others in the delivery of long-term services and supports (LTSS) to older adults and people with disabilities.

The study finds, however, that even the best performing states have a long way to go to create a high-performing system of long-term services and supports. It shows that all states need to vastly improve in areas including home care, assisted living, nursing home care, and supports for family caregivers, and more efficiently spend the substantial funds they currently allocate to LTSS.

The report examines four key dimensions of state LTSS system performance: affordability and access; choice of setting and provider; quality of life and quality of care; and support for family caregivers. It assesses each state’s performance as a whole and on 25 individual indicators, some of which were measured for the first time.

The Scorecard finds generally that states with the highest level of performance have enacted public policies designed to:

Improve access to services and choices in their delivery by directing state Medicaid programs to serve more people in need and offer alternatives to nursing homes that most consumers prefer.

Establish a single point of system entry to help people find needed information and more easily access services.

Improve support for family caregivers by offering legal protections as well as other services to address caregiver needs.